Notice of Intention to Refer Dispute to Adjudication

NationwideAcademy of Dispute Resolution UK Ltd

Stockland Cottage 11 James St, Treforest, Pontypridd Wales CF37 1BU UK : Phone +44(0)1443 486122 : Fax + 44(0)1443 404171

CLAIMANT’S RECORD OF DOMUMENTS SUBMITTED TO MEDIATOR FCSM03C

This form should be completed by the claimant and accompany any documents submitted directly to the mediator. You are advised to send a copy to the other party at the same time. The purpose of this form is to establish a record of documents submitted to the mediator. You should also indicate which documents have already been disclosed, and where applicable, the documents the mediator may disclose, to the other party.

There is no duty to disclose documents in advance of the mediation. However, advance disclosure of information that supports your case affords the other party an opportunity to reflect on the reasonableness of your claim, assists the mediation process and helps you to achieve an early settlement on terms which are advantageous and acceptable to you. By contrast, the introduction of large amounts of information and documentation, for the first time, during a mediation is likely to go over the head of the mediator and the other party and be less effective, or even counter-productive.

CLAIMANT’S NAME: /

V

/ DEFENDANT’S NAME :
► / ►
Date: / ► /

Claim No

/ ► /

Your ref

/ ►

Court

If any: / ► / Claim Ref: / ► /

NADR No

/ ►
We supply this number
DOCUMENTS ACCOMPANYING THIS NOTICE OF SUBMISSION
DOCUMENT REFERENCE NO / TITLE OF
DOCUMENT / CONSENT TO DISCLOSURE / DISCLOSURE / EXCHANGE
► / Written summary of key facts / YES NO / YES NO
► / Written summary of key issues / YES NO / YES NO
► / Written summary of legal basis of claim / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
► / ► / YES NO / YES NO
DISCLOSURE (if any) HAS BEEN MADE TO (1) /

DISCLOSURE (if any) HAS BEEN MADE TO (2)

Name / ► / Name / ►
Officer / ► / Officer / ►
Address / ► / ►
Tel / ► / Fax / ► / Tel / ► / Fax / ►
What to Do Next.
TasksCheckpoint
Check. / ACTIONS / YES / NO
1Have you considered seeking or sought legal advice ? / SOUGHT
2 Send relevant document(s) and copy of this form (Mail or Fax) to
The NADR Administrator
Stockland Cottage, 10 James St, Treforest,
Pontypridd CF37 1BU UK
E-Mail :
Fax : 0044 (0)1443 404171
For transmission to the mediator and to the other party where applicable. / SENT
3Send a copy of this form (Mail/E-mail or Fax) to the other party accompanied by relevant documents (if any) that you wish to disclose. / SENT
AFTER WHICH
4NADR will send you Notice of Mediation (date, time, location etc) / RECEIVED
5Send NADR any outstanding documentation requested. You may receive additional documents from the other party / SENT
6NADR will send you a Notice of Initiation of Mediation Process / RECEIVED
7Notify everyone in your team about attendance details / NOTIFIED
8Attend the Mediation / ATTENDED
We hope that you will be able to reach
a quick, amicable and acceptable
settlement of your dispute.